Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
권호 표지

소아 관찰병실 운영에 대한 분석

An analysis of one-year experience of pediatric observation unit: The first report in Korea

  • 이지영 (가톨릭대학교 의과대학 소아과학교실) ;
  • 최의윤 (가톨릭대학교 의과대학 소아과학교실) ;
  • 이수영 (가톨릭대학교 의과대학 소아과학교실) ;
  • 이지영 (가톨릭대학교 성모자애병원 간호부) ;
  • 이병찬 (성세병원 소아과) ;
  • 황희승 (가톨릭대학교 의과대학 소아과학교실) ;
  • 목혜린 (가톨릭대학교 의과대학 소아과학교실) ;
  • 정대철 (가톨릭대학교 의과대학 소아과학교실) ;
  • 정승연 (가톨릭대학교 의과대학 소아과학교실) ;
  • 강진한 (가톨릭대학교 의과대학 소아과학교실)
  • Lee, Jee Young (Department of Pediatrics, College of Medicine The Catholic University of Korea) ;
  • Choi, Ui-Yoon (Department of Pediatrics, College of Medicine The Catholic University of Korea) ;
  • Lee, Soo Young (Department of Pediatrics, College of Medicine The Catholic University of Korea) ;
  • Lee, Ji-Young (Department of Nursing, College of Medicine The Catholic University of Korea) ;
  • Lee, Byong Chan (Department of Pediatrics, Sung-Se Hospital) ;
  • Hwang, Hui Sung (Department of Pediatrics, College of Medicine The Catholic University of Korea) ;
  • Mok, Hye Rin (Department of Pediatrics, College of Medicine The Catholic University of Korea) ;
  • Jeong, Dae Chul (Department of Pediatrics, College of Medicine The Catholic University of Korea) ;
  • Chung, Seung Yun (Department of Pediatrics, College of Medicine The Catholic University of Korea) ;
  • Kang, Jin Han (Department of Pediatrics, College of Medicine The Catholic University of Korea)
  • 투고 : 2007.05.19
  • 심사 : 2007.06.18
  • 발행 : 2007.07.15
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초록

목 적 : 소아 관찰병실(pediatric observation unit: POU)의 운영내역을 분석하여 국내에서도 그 적용이 가능한지를 평가하기 위함이다. 방 법 : 2006년 3월부터 2007년 2월까지 1년간 가톨릭대학교 성모자애병원 소아과 POU에 입원한 환아들을 대상으로 하여 의무기록을 분석하였고 평균재원일수와 병상회전율을 평가하기 위하여 연구기간 1년 전 자료와 비교하였다. 결 과 : 총 1,076명이 POU에 입원하였으며 환아들의 중앙 연령은 2.4세이었고 중앙 재원시간은 14시간 00분이었다. 질환별로는 장염(42.7%)이 가장 많았고 그 외 급성인후염(19.1%), 모세기관지염(7.8%), 폐렴(5.5%), 열성경련(5.2%) 순이었다. 전체 환아 중 7.5%(81/1,076명)는 일반입원으로 전환되어 입원이 연장되었다. 전환율이 낮은 질환들은 변비와 장염, 중이염과 인후염을 포함한 상기도 감염성 질환, 경련성 질환, 후두염이었고 전환율이 높은 질환들은 폐렴, 발열이 조절되지 않은 열성경련, 천식이었다. POU 시행 1년전 자료와 비교할 때, 전체 입원환자의 평균 재원일수는 4.69일에서 3.75일로 감소하였고 병상회전율은 1병상 당 78.8명에서 98.2명으로 증가하였다. 결 론 : POU는 국내에서도 효율적으로 운영될 수 있음을 확인하였다. 향후 POU는 외래와 응급실 진료의 제한점을 보완하며 불필요한 입원기간을 줄일 수 있는 소아과 영역의 새로운 진료 형태로 자리잡을 수 있을 것이라고 기대한다.

Purpose : While pediatric observation units (POU) have become a common practice in hospitals throughout developed countries, there has been no report about POUs in Korea so far. The aims of this study were to analyze our one-year's experience of the POU and to decide which disease entities are suitable for the POU. Methods : All children admitted from March 2006 to February 2007 to the POU at the Department of Pediatrics in Our Lady of Mercy Hospital were included in this study. Data were collected from retrospective reviews of their medical records. Results : There were a total of 1,076 POU admissions. Median age of patients was 2.4 years and median length of hospital stay 14.0 hours. The most common diagnoses were gastroenteritis (42.7%), pharyngotonsillitis (19.1%), bronchiolitis (7.8%), pneumonia (5.5%) and febrile seizure (5.2%). Overall, 7.5% of the POU patients required subsequent inpatient admissions due to hospital stays of longer than 48 hours. The disease entities that were most likely to require inpatient admission were pneumonia (17.0%), febrile seizure (12.5%) and asthma (11.5%). Diseases that allowed successful discharge from the POU were gastroenteritis (4.6%), upper respiratory tract infection (5.8%), such as otitis media and pharygnotonsillitis and seizure disorder (6.4%). Compared with the previous year when the POU was not in operation, there was a statistically significant reduction in the average length of hospital stays (from 4.69 to 3.75 days), as well as a rise in the bed turnover rate (from 78.8 to 98.2 patients/bed). Conclusion : Our study shows that the POU is efficient for the management of children with certain acute illnesses. Based on this study, we suggest that the POU be used as a new modality which links between the outpatient, inpatient, and emergency departments in the field of pediatrics in Korea.

키워드

참고문헌

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